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Clinical investigations from the RACP

Investigating the patient with venous thromboembolic disease

Ian Prosser, Philip Crispin

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Abstract

The aims of investigation of patients with venous thromboembolic disease (VTE) are to identify occult predisposing conditions, estimate the probability of recurrence and direct further management.

Key Points

  • Venous thromboembolism (VTE) is multifactorial, with both congenital and acquired risk factors.
  • VTE may be the first presentation of systemic illness.
  • It is not necessary to investigate patients who have VTE following recent major surgery or other identified temporal risk factors.
  • Investigating for underlying systemic disease should be guided by careful history, examination and consideration of risk factors.
  • Identifying single gene defects, such as factor V Leiden, usually does not change management.
  • Specialist advice is suggested for multiple inherited defects or strongly thrombophilic defects, such as antithrombin deficiency.

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